Childhood trauma increases social functioning deficits, which in turn negatively impact social inclusion in those experiencing first-episode psychosis (FEP). Associations between aberrant higher-order social cognitive processes such as emotion recognition (ER) and trauma severity may be one pathway by which trauma negatively impacts social functioning.

Given sex differences identified in the experience of childhood trauma, it is pertinent to evaluate how trauma severity may differentially impact ER in males and females.

Eighty-three FEP participants (52 males, 31 females) and 69 nonclinical controls (49 males, 20 females) completed the CogState Research Battery. FEP participants completed the Childhood Trauma Questionnaire. A sex × group (FEP, controls) ANOVA examined ER differences and was followed by two-way ANCOVAs investigating the effects of sex and childhood trauma severity (none, low, moderate, severe) on ER and global cognition in FEP.

FEP participants had significantly lower ER scores than controls (p = .035). In FEP, a significant interaction emerged between sex and childhood trauma severity (F(3, 72) = 6.382, p = .001), selective to ER, while controlling for age at onset. Simple effects analyses revealed that females in the severe trauma category exhibited superior ER capacity relative to males.

The differential impact of trauma severity on ER in males and females with FEP may be theoretically interpreted as the distinct way that hypervigilance affects the sexes. Early intervention services should refine social cognitive interventions in male and female trauma survivors to facilitate social functioning improvements.

Funding: This study was supported by the Canadian Institutes of Health Research (#68961) to M.L. and A.M. Salary awards include: The Fonds de recherche du Québec - Santé to M.L. and R.J., the James McGill Professorship to M.L., and the Canada Research Cha

There is a limited literature available showing mental health burden among adolescents following cyberbullying.

Aim is to evaluate the association of low mood and suicidality amongst cyberbullied adolescents.

A study on CDC National Youth Risk Behavior Surveillance (YRBS) (1991-2017). Responses from adolescence related to cyberbullying and suicidality were evaluated. Chi-square and mix-effect multivariable logistic regression analysis was performed to find out the association of cyberbullying with sadness/hopelessness, suicide consideration, plan, and attempts.

A total of 10,463 adolescents, 14.8% of adolescents faced cyberbullying a past year. There was a higher prevalence of cyberbullying in youths aged 15-17 years (25 vs 26 vs 23%), which included more females to males (68 vs 32%).(p<0.0001) Caucasians (53%) had the highest number of responses to being cyberbullied compared to Hispanics (24%), African Americans (11%).(p<0.0001) There was an increased prevalence of cyberbullied youths with feelings of sadness/hopelessness (59.6 vs 25.8%), higher numbers considering suicide (40.4 vs 13.2%), suicide plan (33.2 vs 10.8%), and multiple suicidal attempts in comparison to non-cyberbullied.(p<0.0001) On regression analysis, cyberbullied adolescence had a 155% higher chance of feeling sad and hopeless [aOR=2.55; 95%CI=2.39-2.72], considered suicide [1.52 (1.39-1.66)], and suicide plan [1.24 (1.13-1.36)].

In our study, cyberbullying was associated with negative mental health outcomes. Further research is warranted to examine the impact and outcomes of cyberbullying amongst adolescents and guiding the policies to mitigate the consequences.

No significant relationships.

DSM-V includes near-psychotic symptoms as new criteria in borderline personality disorder (BPD). This change makes more difficult the differential diagnosis between considering psychotic symptoms as part of the BPD or as part of a comorbid psychotic disorder.

Recognize the difficulty of the differential diagnosis in clinical practice between BPD and comorbid diagnosis of BPD with psychotic disorders, and how it can affect the patient’s outcome.

Patients’ data is obtained from medical history and psychiatric interviews carried out during their hospitalizations.

32 year-old female patient with previous diagnosis of BPD, psychotic episodes and cannabis abuse, was admitted due to paranoid ideation and aggressiveness, with massive borderline defense mechanisms (frequent displays of anger, high impulsivity, low frustration tolerance, self-destructive behavior…). Psychotic symptoms ceased two weeks after admission, and considering the patient’s individual characteristic it was believed BPD fitted more with this clinical case, although different psychotic disorders were considered. 30 year-old female patient began intensive psychiatric treatment with previous diagnosis of BPD, psychotic disorder and cannabis abuse. It was observed that the paranoid ideation and bodily experiences she suffered lasted months and were characterized by a strong belief. These two reasons were put into consideration when it was decided to judge this clinical case as a comorbid diagnosis of BPD with a psychotic disorder.

It is necessary to assess the difficulty of the differential diagnosis in these patients, and offer them specialized treatment depending on the diagnosis, as it can affect the patient’s outcome.

No significant relationships.

The situation of Covid-19 disease, associated with a high threat to life and uncertainty, had not only somatic, but also psychological consequences for most patients. Emotional reactions of patients to hospitalization and ways to cope with what is happening have become the subject of study in different countries.

To assess the severity of signs of depression and anxiety and to study the methods used to regulate the emotional state in patients with COVID-19 at the time of hospitalization.

The study volunteered 127 hospitalized patients with Covid-19 (67 men (52.8%) and 60 women (47.2%), aged 19 to 77 years, who completed the following methods: Sociological questionnaire, Beck Depression Questionnaire, GAD-7, F-SOZU-22, CERQ, Dembo-Rubinstein self-assessment scales. The study was conducted from 04/25/2020 to 05/31/2020.

A quarter of patients showed pronounced signs of depression and anxiety (25.4% and 24.13%, respectively), with women having higher rates of depression (M = 8.76 and M = 6.32, p<0.01). Anova showed no significant differences in the response to the disease situation in patients of different age groups. Factor analysis made it possible to identify 3 patterns of emotional coping with the disease: «positive decision oriented», «fixed on negative experiences», «accusers» (The resulting factor solution explains 69% of the dispersion). None of the identified patterns were associated with a significant reduction in signs of depression and anxiety.

Despite the duration of the pandemic, there is still no specific pattern of effective coping with these experiences for patients.

No significant relationships.

Inflammatory bowel disorders (IBD) are chronic diseases with severe course. In this regard, research aimed at identifying adaptive behavior styles potentially significant for individual resilience to disease-related stress is of particular importance

The study population included 45 patients with the inflammatory bowel disorders: 19 male, 26 female (mean age 36,0±4,8), whose clinical and experimental psychological characteristics were studied.

The following methods were used: ‘Life Style Index’ by R. Plutchik, Н. Kellerman, ‘Ways of Coping’ by R. Lazarus, S. Folkman.

The experimental psychological study revealed interdependence of psychological defense mechanisms and coping behaviors. Thus, in female patients, such psychological defense mechanisms as ‘denial r=-0,51’ and ‘compensation г=-0,43’ showed negative correlation with ‘planning problem-solving’ coping strategy and positive correlation with such coping strategies, as ‘escape - avoidance г=0,38’ and ‘confrontation г=0,32’ р<0,05; in male patients, such psychological defense mechanisms as ‘regression г= -0,41;’ and ‘displacement г= -0,30’ demonstrated negative correlation with ‘planning problem-solving’ and ‘exercising self-control’, but positive correlation with such coping strategies, as ‘escape - avoidance г= 0,34’, ‘confrontation г= 0,40;’, р<0,05. Maladaptive attitude towards disease correlated with avoidance reactions in both male and female patients, which is indicated by the central rank position in disease coping structure of ‘confrontation’ coping strategy М=69,3±0,1, along with insufficient utilization of ‘planning problem-solving’ coping strategy М=39.3± 0,1, р< 0,001.

The identified manifestations of psychological maladaptation in both male and female inflammatory bowel disorder patients are moderately pronounced, but require psychotherapeutic correction

No significant relationships.

The clinical evidence and cost-effectiveness of digitalised prevention and treatment of mental disorders such as depression, anxiety and alcohol misuse have been steadily growing over the last two decades. However, bridging the gap between evidence-based eMental-health interventions and their actual delivery, evaluation and implementation in routine care has proven to be more difficult and a longer process than previously expected thereby reaching the estimated forecast of Roger’s innovation cycle of 20 years. In contrast, during the appearance of COVID-19 in 2020 for many patients and therapists digitalized treatment was the only option. Meanwhile from a scientific and policy perspective the implementation and upscaling of digital mental health care innovations in routine care have gained momentum in terms of theoretical perspectives on organizational change, empirical research into how to effectively implement digital innovations from the perspective of a variety of stakeholders and organizational levels (micro, macro and meso). In this presentation an overview of these issues will be presented, and it will be discussed whether COVID-19 might act as a turning point for the provision of large scale access to and implementation of digitalized mental health care in the near future.

No significant relationships.

In the U.S. approximately11.4 million misused prescription pain relievers; 2.1 million had an OUD in 2017. The Addictions Nursing Subspecialty was created to address this epidemic by expanding a workforce trained in OUD/SUD screening, treatment, and prevention. A curriculum was developed that included integrated/telehealth health care settings in medical and mental health provider shortage areas during their last nine months of training. Courses were developed and taught by aninterprofessional team of university faculty and informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery. Courses were also offered as electives for nursing, clinical-counseling, social work, and other health science disciplines emphasizing an interdisciplinary approach to healthcare.

Expand the OUD/SUD trained workforce in areas with high OUD/SUD mortality rates and high mental health provider shortages emphasizing team-based integrated care and telehealth settings.

Program curriculum was informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery using integrated care. Competencies included: Core Competencies for Integrated Behavioral Health and Primary Care that have been set forth by the Center for Integrated Health Solutions, telehealth competencies outlined in the recommended competencies by the National Organization of Nurse Practitioner Faculties (NONPF), and Core Competencies for Addictions Medicine by the American Board of Addictions Medicine.

Approximately 11 students enrolled in courses received additions integrated/telehealth health care settings. Students responded positively to evaluations regarding timely feedback, unique approach (i.e. intrative content, short videos and discussions).

The Addictions Nursing subspecialty will continue to be offered allowing enrollment for nurses twice a year.

Attention-Deficit/Hyperactivity Disorder (ADHD) and Obesity are frequently comorbid. The prevalence of ADHD rises from around 2.8% in the general population (adults) to about 27% among those with obesity. Although neurobiological mechanisms explaining the strong association between ADHD and obesity are still unclear, several hypotheses have been proposed to explain the high comorbidity, including common genes, dopaminergic neurotransmission, deficits in executive functions (planning, adherence to weight loss programs or protocols after bariatric surgery) and circadian rhythm dysregulation.

Review on the relationship between ADHD and Obesity, focusing on possible biological mechanisms driving their high comorbidity.

We conducted a search in PubMed and ClinicalKey with the terms: “Attention-Deficit/Hyperactivity Disorder”, “Obesity”, “Dopamine”.

Altered reward processing and impaired inhibitory control are key features of ADHD and are also related to obesity. The ability to resist the impulse to eat and an appropriate reward response require normal function of these dopamine circuits. Both ADHD and obesity are usually associated with reduced volume of putamen, known to be a fundamental player in inhibitory control functioning. Human and animal studies have also demonstrated that obese individuals have decreased dopamine D2 receptor availability in the striatum. Recently genetic analyses implicated specifically Dopamine-DARPP32 Feedback in cAMP Signaling in both ADHD and Obesity.

ADHD and obesity are often comorbid. Dysregulated dopaminergic neurotransmission seems to be a fundamental factor underlying the overlap between ADHD and obesity, probably involving DARPP-32 signaling and possibly through neurobiological features of putamen, namely inhibitory control. Further studies are necessary to explain the neurobiological correlation between these entities.

No significant relationships.

No significant relationships.

Acute and chronic exposure to cadmium (Cd), due to its increased use and application in the industry, can result in the development of atherosclerosis, the occurrence of cardiomyopathy, cerebrovascular stroke, as well as carcinogenesis in some organs. The target for cadmium action is thought to be the vascular endothelium.

The aim of this study is to investigate the occurrence of oxidative stress on blood vessel endothelium induced by subacute administration of cadmium, as well as the protective power of alpha-lipoic acid (α-LA) supplementation on the Wistar strain albino rat model system.

After anesthesia of rats in the vivarium of the Scientific Research Center for Biomedicine, Faculty of Medicine in Niš, blood was collected by cardiac puncture and sent to the Clinic of Nephrology, Clinical Center in Niš, Serbia for determination of hematological parameters.

According to the results of this study, it can be seen that the number of granulocytes is reduced due to cadmium intoxication, which is probably induced by the migration of neutrophils into tissues. The number of lymphocytes was increased due to subacute cadmium intoxication compared to the control group of animals. The positive efficacy of α-LA supplements in combating the adverse effects of cadmium on blood vessels is also confirmed.

Cadmium administration is thought to cause a systemic inflammatory reaction due to the formation of free radicals in the blood vessel endothelium. Administration of α-LA supplement confirms that it can be used as an antioxidant in the clinical management of many diseases and also in cadmium intoxication.

No significant relationships.

In the continuous work to reduce the use of coercion in the psychiatric care, attention in Denmark has especially been directed towards mechanical restraint, i.e. the use of belts to fixate patients to a bed. While the use of mechanical restraint is currently decreasing, increases in other types of coercive acts are observed (e.g., forced medication and hourly episodes of manual restraint). The use of manual restraint refers to mental health workers immobilizing a patient to avoid harm to self or others. Manual restraint is generally considered less intrusive to a patient’s autonomy than the use of mechanical restraint. However, no study has yet explored if it is actually experienced as such by the patients.

This study explores patients’ perspectives on manual and mechanical restraint, respectively.

We are currently performing a qualitative interview study of 10 patients, who have been exposed to both types of coercion. The interviews will be transcribed verbatim and analysed for thematic content.

We expect to discover more nuanced perspectives of the intrusiveness of the different forms of coercion—perspectives that may challenge the assumption that one type of coercion is by default better than another. The study’s results will be presented.

In this study, we only look at two types of coercion. More investigation into the differentiation of patients and ideal type of coercive measure is paramount to the ambitions of a better and more humanistic psychiatric care.

Benjamin Rolland declare having received fees for lectures and expertise from Ethypharm. He was the principal investigator of a phase-1 study funded by Ethypharm

The tryptophan pathway along with its two branches of metabolism to serotonin and kynurenine seems to be affected in major depression. In depressed patients, peripheral levels of tryptophan, serotonin, kynurenine and their metabolite remain unclear.

Therefore, peripheral tryptophan and metabolites of serotonin and kynurenine were investigated extensively in 173 patients suffering from a current major depressive episode (MDE) and compared to 214 healthy controls (HC).

Fasting plasma levels of 11 peripheral metabolites were quantified: tryptophan, serotonin pathway (serotonin, its precursor 5-hydroxy-tryptophan and its metabolite the 5-hydroxy-indole acetic acid), and kynurenine pathway (kynurenine and six of its metabolites including anthranilic acid, kynurenic acid, nicotinamide, picolinic acid, xanthurenic acid and 3-hydroxy-anthranilic acid).

60 (34.7%) patients were antidepressant drug free. Tryptophan levels did not differ between MDE patients and HC. Serotonin and its precursor (5-hydroxy-tryptophan) levels were lower in MDE patients than HC. Whereas, its metabolite (5-hydroxy-indole acetic acid) levels were within the standard range. Kynurenine and four of its metabolites (kynurenic acid, nicotinamide, picolinic acid and xanthurenic acid) were lower in MDE patients.

This study uses the largest ever sample of MDE patients, with an extensive assessment of peripheral tryptophan metabolism in plasma. These findings provide new insights into the peripheral signature of MDE. The reasons for these changes should be further investigated. These results might suggest a better stratification of patients and different therapeutic strategies therapeutic strategies.

Digital solutions and interventions for mental health have increasingly been taking place in many societies in the last several decades. There are significant differences among countries due to economical and organizational situations. On the other hand, despite digital gap, there is a significant increase in the use of telepsychiatry and e-mental health applications with the Covid-19 pandemic throughout the world. Experiences of this pandemic times make many opportunities and challenges more apparent in this field. Safety and security, legislation, regulations, good practice standards, evidence based data, ethics and education are several of main areas of needs. EPA with the Council of National Psychiatric Associations (NPAs) is one of the crucial organizations in Europe which may play an important role to work on these challenges and opportunities. EPA-Council of NPAs consists of 44 associations represent psychiatrists (and other mental health workers in some) from 40 European countries. NPAs are crucial organisations in contact with local and national mental health stakeholders; competent in national, local, authentic and cultural issues and sensitivities; and could serve as crucial junctions for Europewide policies and their widespread implementations. Some reflections on challenges and opportunities from the Council of NPAs will be presented, based on a rapid survey and personal communications with presidents and official representatives of NPAs for future perspectives.

No significant relationships.

Precision medicine is “an emerging approach for treatment and prevention that takes into account each person’s variability in genes, environment, and lifestyle” [1]. The terminology is increasingly used in psychiatry, and especially in research relevant to the prediction of psychosis onset, response to treatment and functional outcome. While this is an important step-forward for the discipline, at this stage it is very important to promote the translation of research findings into clinical practice, as much as possible. Nowadays the availability of machine learning and artificial intelligence tools, together with advances in data storage and data security, enable the integration of neuroimaging, biological, clinical and cognitive data. By overcoming current limitations in multiple domain data analysis these tools may lead to the identification of reliable diagnostic, prognostic and therapeutic markers in routine clinical care, as well as to the prediction of clinically meaningful outcomes (e.g., psychosis onset, symptomatic and functional outcome, and treatment response). Precision medicine in psychiatry is a developing science, deserving further large-scale research, translational approaches and refinement that, hopefully, will soon be an integral part of every-day clinical practice. However, challenges in pursuing this strategy should not be underestimated, and efforts should be made to constantly advocate for more investments in human and financial resources in psychiatry, and to concentrate on the use of widely available and not too expensive and time-consuming methods.1 Toward Precision Medicine. Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. Washington, DC: National Academies Press; 2011.

No significant relationships.

In spite of the long history of antipsychotic treatment there are still no clear criteria, which can be robust support for drug decision-making.

To determine the important hallmarks of patient’s current state, life span and history of illness defining the doctor’s decision about the type of antipsychotic to be chosen.

The data from the case charts of 275 patients with episodic schizophrenia and rather benign course of the disease were analyzed.

The group included: male 62%, mean age 33 (SD 11), education 10 years 23%, 13 years 27%, 16 years 29%, disability - 51%, number of hospitalizations due to psychotic episodes in the past 7 (SD 6). The symptoms of the current episode varied from patient to patient: delusions and hallucinations, symptoms of disorganization, negative symptoms of different severity were registered Atypical antipsychotics were more often than typical prescribed to the patients with developmental problems: traumatic obstetric complications (p=0,009), poor somatic health in the childhood (p= 0,02), cognitive dysfunction during school years (p=0,04), and quality of first remission – presence of residual symptoms in the first remission (p=0.005). Good compliance in the past was one more important factor for choosing a atypical antipsychotic for a patient (p=0.05). It appeared that the most important for the decision-making was the specific features of the patient’s development and early period of the disease, but not the specific signs of current psychotic state.

Doctor’s decision upon the type of antipsychotics in this category of patients is most probably based on other than current clinical symptoms signs.

The Covid-19 pandemic has limited the classic psychotherapy treatment. EAP provided temporary recommendations for online psychotherapy in March of 2020 which brought new possibilities and limitations and contains rules, ethics and techniques. From the perspective of a psychodynamic therapist, the specificity of online group psychotherapy in the context of strong stressors is described.

During the “lockdown” period and the earthquakes that occurred simultaneously in Zagreb in March of 2020, the secure Internet platform enabled the continuity of the group’s work in a video link modality.

Online group had regular weekly meetings which lasted 1.5 hours. The classic rules of group analytical therapy were adapted to the new setting in virtual space. A risk assessment was also performed.

The six group members and therapist have connected online through more freedom, developed new levels of sensitivity, flexibility and creativity. They have also accepted limitations. The online group is able to provide holding, but deeper connections require a physical presence to exchange emotions that technology interferes with as well as the process of empathizing. Previous live sessions crucial to maintaining emotional connections have served as reservoirs for a period in which communication over the Internet was insufficient.

Internet technology can temporarily enable the continuity of a group psychotherapy. Technical and institutional support is recommended. The advantages of technology can be used if the technique is adapted, realistic goals set, and clinical limitations accepted. Many questions about the possibilities of “online psychotherapy” are open and unexplored.

No significant relationships.